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Treatments and drugs
By Mayo Clinic staffSurgery is required to treat testicular torsion. In some cases, the doctor may be able to untwist the testicle by pushing on the scrotum (manual detorsion), but you'll still need surgery to prevent torsion from occurring again. If testicular torsion occurs before birth, surgery may not be possible.
Surgery for testicular torsion is usually done during general anesthesia, which means you won't be conscious. The surgery is straightforward and generally doesn't require a stay in the hospital. During surgery, your doctor will:
- Make a cut in your scrotum — a loose bag of skin under your penis that contains your testicles
- Untwist your spermatic cord, if necessary
- Stitch one or usually both testicles to the inside of the scrotum to prevent rotation
The sooner the testicle is untwisted, the greater the chance of successful treatment:
- Within six hours, the testicle can be saved about 90 percent of the time
- After 12 hours, chances of saving the testicle fall to about 50 percent
- After 24 hours, the testicle can be saved only about 10 percent of the time
After surgery, you'll need to avoid strenuous activity, including sexual activity, for several weeks. Ask your doctor when it's OK to resume normal activities, including sex.
Testicular torsion in newborns and infants
In some cases, surgery is needed to diagnose and correct testicular torsion. This can prevent future issues with fertility or male hormone production. Deciding whether a newborn or infant should have surgery depends on the judgment of the doctor, and in some cases, the desires of the parent.
- After birth. If a boy is born with signs and symptoms of testicular torsion, it may be too late for emergency surgery to help. In some cases, the doctor may recommend a later, nonemergency surgery.
- Before birth. If signs and symptoms of testicular torsion occur after birth, the doctor may recommend emergency surgery.
- Tiemstra JD. Evaluation of scrotal masses. American Family Physician. 2008;78:1165.
- Leslie JA, et al. Pediatric urologic emergencies and urgencies. Pediatric Clinics of North America. 2006;53:513.
- Schneck FX, et al. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/171051125-2/913428548/1445/130.html?printi. Accessed Nov. 6, 2009.
- Testicular torsion. American Urological Association Foundation. http://www.urologyhealth.org/search/index.cfm?topic=134&search=men&searchtype=and. Accessed Nov. 13, 2009.
- Hittelman A. Neonatal testicular torsion. http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2009.
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